Individual
LAUREN ELIZABETH LEYVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 SEYMOUR ST, HARTFORD, CT 06102-8000
(860) 972-1911
Mailing address
80 SEYMOUR ST, HARTFORD, CT 06102-8000
(860) 972-1911
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002878
CT
363AM0700X
Medical Physician Assistant
002878
CT
363AS0400X
Surgical Physician Assistant
002878
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003028784
—
CT
Enumeration date
03/05/2013
Last updated
07/21/2022
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